Boris P Eckhardt

Publications (9)17.55 Total impact

• Source

  Available from: Samya Z Nasr

  Article: The use of high resolution computerized tomography (HRCT) of the chest in evaluating the effect of tobramycin solution for inhalation in cystic fibrosis lung disease.

  Samya Z Nasr, Ermelinda Sakmar, Emmanuel Christodoulou, Boris P Eckhardt, Daniel S Streetman, Peter J Strouse
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  ABSTRACT: To compare the usefulness of HRCT of the chest versus spirometric measures (PFTs) in evaluating the effect of tobramycin solution for inhalation (TSI) in cystic fibrosis (CF). Thirty-two CF patients with mostly mild lung disease age > or = 6 years, were enrolled in a double-blind, placebo-controlled pilot study. Patients were chronically colonized with Pseudomonas aeruginosa for at least 6 months prior to and at enrollment. If patients were on TSI, they were taken off for at least 3 months prior to enrollment. Duration was 6 months; 31 subjects completed the study. HRCT and PFTs were evaluated at baseline, after 28 days of treatment and at the end of the study. Study medication was administered as 5 ml nebulized treatment twice a day for 28 days followed by 28 days off (one cycle). Study consisted of three cycles. Two radiologists scored all films using a validated system. A total HRCT score consists of the sum of subscores: linear opacities, hyperinflation, nodular opacities, peribronchial thickening, mucous plugging, and bronchiectasis; each subscore could range from 0 to 80, with potential total scores varying from 0 to 480. The percent of the maximum possible HRCT score was then calculated and used for all comparisons. Using two tailed paired t-test, the percent maximum HRCT score decreased by 1.4 +/- 2.6% (mean +/- SD) (P = 0.049) and 0.3 +/- 2.8% (P = 0.63) for the TSI group and decreased by 0.1 +/- 1.5% (P = 0.74) and increased by 0.6 +/- 1.8% (P = 0.23) for the placebo group between visits 1 and 2, and visits 1 and 3, respectively. The data were then analyzed using a mixed model utilizing changes in scores over the durations of the study for each group. The change of HRCT score for the TSI group was -0.24/day (P = 0.02) and -0.03/day (P = 0.22), and for the control group the change was -0.01 (P = 0.93) and 0.02 (P = 0.29) between visits 1 and 2, and visits 1 and 3 respectively. FEF(25-75)% and FEV(1)% changes were not statistically significant using both analyses. HRCT seems to be more sensitive in detecting treatment effect than PFT in CF patients with mild lung disease, especially following the first treatment period (visit 2). Total HRCT score showed some improvement at the end of the study, though not statistically significant. This is probably due to obtaining the HRCT an average of 30 days after completion of the TSI treatment, and selection of study population with mostly mild lung disease. This could indicate that the most significant improvement in the total HRCT score in this patient population occurs after the first treatment period with TSI.
  Pediatric Pulmonology 05/2010; 45(5):440-9. · 2.53 Impact Factor
• Article: Comparison of diffusion-weighted whole body MRI and skeletal scintigraphy for the detection of bone metastases in patients with prostate or breast carcinoma.

  Andreas Gutzeit, Aleksis Doert, Johannes M Froehlich, Boris P Eckhardt, Andreas Meili, Patrick Scherr, Daniel T Schmid, Nicole Graf, Constantin A von Weymarn, Edwin M M Willemse, Christoph A Binkert
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  ABSTRACT: To prospectively compare the diagnostic accuracy of diffusion-weighted whole body imaging with background whole body signal suppression (DWIBS) with skeletal scintigraphy for the diagnosis and differentiation of skeletal lesions in patients suffering from prostate or breast cancer. A diagnostic cohort of 36 patients was included in skeletal scintigraphy and 1.5 T DWIBS MRI. Based on morphology and signal intensity patterns, two readers each identified and classified independently, under blinded conditions, all lesions into three groups: (1) malignant, (2) unclear if malignant or benign and (3) benign. Finally, for the definition of the gold standard all available imaging techniques and follow-up over a minimum of 6 months were considered. Overall, 45 circumscribed bone metastases and 107 benign lesions were found. DWIBS performed significantly better in detecting malignant skeletal lesions in patients with more than 10 lesions (sensitivity: 0.97/0.91) compared to skeletal scintigraphy (sensitivity: 0.48/0.42). No statistical difference could be found between DWIBS (0.58/0.33) and skeletal scintigraphy (0.67/0.58) in the sensitivity values for malignant skeletal lesions in patients with less than 5 lesions. For benign lesions, scintigraphy scored best with a sensitivity of 0.93/0.87 compared to 0.20/0.13 for DWIBS. Interobserver agreement with Cohen's kappa coefficient was calculated as 0.784 in the case of scintigraphy and 0.663 for DWIBS. With respect to staging, in prostate and breast carcinoma, the DWIBS technique is not superior to skeletal scintigraphy, but ranks equally. However, in the cases with many bone lesions, markedly more metastases could be discovered using the DWIBS technique than skeletal scintigraphy.
  Skeletal Radiology 04/2010; 39(4):333-43. · 1.54 Impact Factor
• Article: Improved vessel delineation in keyhole time-resolved contrast-enhanced MR angiography using a gadolinium doped flush.

  Jan Beranek-Chiu, John M Froehlich, Klaus U Wentz, Alexis N Doert, Christoph L Zollikofer, Boris P Eckhardt
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  ABSTRACT: To prospectively assess the influence of a gadolinium doped saline flush compared with a pure saline flush on the image quality of the supra-aortic vessels using time-resolved contrast-enhanced MR angiography (4D CE-MRA) in a randomized double blind clinical trial. Twenty-two patients scheduled for contrast-enhanced craniocerebral MRI underwent a supplemental 4D CE-MRA covering the carotids to the superior sinus consisting of 30 dynamics of a T1-weighted 3D gradient-echo sequence (FFE) in sagittal direction. The temporal resolution of 1.1 s per dataset was achieved using the keyhole technique with the reference scan acquired at the end. Immediately after the intravenous (IV) injection of 0.1 mmol Gd/kg body weight of gadoterate, our patients received a 50-mL flush consisting either of a 0.9% saline solution (n = 11) or doped with 50 mM gadolinium (n = 11; total Gd: 0.11 mmol/kg) at a flow-rate of 2 mL/s. Vessel delineation, image quality, signal-to-noise- (SNR) and contrast-to-noise (CNR) ratios over time were compared. Both vessel delineation (internal carotid artery [ICA]: slope(saline) = 308.5; slope(Gd) = 528.9; P = 0.006; superior sagittal sinus [SSS]: slope(saline) = 505.3; slope(Gd) = 674.9; P = 0.007) and CNR (ICA: CNR(saline) = 57.3; CNR(Gd) = 80.55; P = 0.0417; SSS: CNR(saline) = 74.15; CNR(Gd) = 117.4; P = 0.0331) of the ICA and SSS were significantly increased using the gadolinium doped flush. A low concentrated gadolinium flush in comparison to a pure saline flush improves significantly vessel contrast and their delineation in time-resolved CE-MRA using the keyhole technique.
  Journal of Magnetic Resonance Imaging 05/2009; 29(5):1147-53. · 2.70 Impact Factor
• Source

  Available from: Samya Z Nasr

  Article: High resolution computerized tomography of the chest and pulmonary function testing in evaluating the effect of tobramycin solution for inhalation in cystic fibrosis patients.

  Samya Z Nasr, Diane Gordon, Ermelinda Sakmar, Xin Yu, Emmanuel Christodoulou, Boris P Eckhardt, Peter J Strouse
  [show abstract] [hide abstract]
  ABSTRACT: To evaluate the sensitivity of high-resolution computerized tomography (HRCT) of the chest compared to spirometry measures in evaluating the effects of tobramycin solution for inhalation (TSI) in cystic fibrosis (CF) patients.Thirty-two subjects >/=6 years old with mild to moderate CF lung disease were enrolled in a randomized, double-blind, placebo-controlled pilot study. Duration was 28 days; 31 subjects completed the study.HRCT scores decreased 4.06 +/- 3.20 (mean +/- SD) for TSI and decreased 0.17 +/- 1.78 for placebo subjects (P = 0.13). Mean forced expiratory flow during middle half of forced vital capacity (FEF(25%-75%)) predicted increased 6.08 +/- 4.86 for TSI and decreased 0.60 +/- 2.34 for placebo (P = 0.23). Percentage forced expiratory volume in 1 s (FEV(1)) predicted increased slightly for both TSI and placebo (1.29 +/- 3.33 for TSI and 1.17 +/- 1.4 for placebo) (P = 0.97). Two of eight HRCT component scores (atelectasis and inhomogeneity) were observed to be highly discordant with observed HRCT global total score and other HRCT component scores. A modified total score was calculated by dropping them from the global total score. The modified HRCT total scores decreased 6.68 +/- 3.09 for TSI subjects and increased 0.02 +/- 2.0 for the placebo subjects (P = 0.07). Sample sizes were calculated to show statistical significance by differences in modified total HRCT scores, global total HRCT scores, FEF(25%-75%) predicted or FEV(1) % predicted. A total of 60, 100, 200, and over 800 patients would be necessary respectively.HRCT can be a useful measure of change in CF pulmonary disease, requiring a smaller sample size than that required to show treatment effect by pulmonary function testing (PFT) alone.
  Pediatric Pulmonology 01/2007; 41(12):1129-37. · 2.53 Impact Factor
• Source

  Available from: umich.edu

  Article: Ultrasonography of the annular ligament partial tear and recurrent "pulled elbow".

  Moon C Kim, Boris P Eckhardt, Clifford Craig, Lawrence R Kuhns
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  ABSTRACT: A 2-year-old boy had multiple episodes of radial head subluxation, recurrent "pulled elbow." On initial ultrasonography, there was subluxation of the radial head in relation to the capitellum, and the annular ligament was partially disrupted. Following brace treatment, subluxation of the radial head was corrected and annular ligament disruption healed. As shown by ultrasonography, these findings correlated well with the clinical course and can be utilized to guide treatment.
  Pediatric Radiology 01/2005; 34(12):999-1004. · 1.67 Impact Factor
• Article: Pigmented villonodular synovitis: MR imaging in pediatric patients.

  Boris P Eckhardt, Ramiro J Hernandez
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  ABSTRACT: To describe the usefulness of gradient-echo imaging and contrast-enhanced MR imaging in diagnosing and assessing the extent of pigmented villonodular synovitis (PVNS) in pediatric patients. Retrospective analysis of five pediatric patients (median age 14 years) with PVNS of the knee examined with a 1.5-T unit. Signal characteristics were obtained comparing T1- and proton-density (PD)-weighted imaging with gradient-echo imaging and enhanced imaging. The extent of the disease was assessed using the arthroscopic approach. Signal intensity ratios were statistically analyzed. Compared to PD- and T1-weighted imaging sequences, gradient-echo imaging provides superior depiction of the extent of the disease due to signal decay (T2*-effect) of hemosiderin-laden thickened synovium and masses. Inflamed synovium with low hemosiderin deposition was identified on enhanced imaging. Beside the suprapatellar bursa and Hoffa's fat pad, the area posterior to the cruciate ligaments is commonly involved. No bony abnormalities were present. Gradient-echo imaging together with enhanced imaging is useful in diagnosing and assessing the extent of PVNS in pediatric patients. A low signal mass behind the cruciate ligaments may represent an important diagnostic feature. Bony abnormalities were always absent.
  Pediatric Radiology 01/2005; 34(12):943-7. · 1.67 Impact Factor
• Article: Primary cerebral leiomyosarcoma in a child.

  Boris P Eckhardt, Sebastian Brandner, Christoph L Zollikofer, Klaus U Wentz
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  ABSTRACT: We present a 13-year-old boy with a low-grade primary intra-axial cerebral leiomyosarcoma. MRI showed a contrast-enhancing intra-axial mass with features of a cell-rich tumour. The diagnosis was established after neurosurgery and exclusion of an extracerebral primary tumour. The resection of local recurrence 6 months later confirmed the diagnosis, but a higher grade of malignancy was established. The patient died 15 months after the onset of symptoms from general intracranial and intraspinal spread.
  Pediatric Radiology 07/2004; 34(6):495-8. · 1.67 Impact Factor
• Article: Giant cardiac myxoma with malignant transformed glandular structures.

  Boris P Eckhardt, Corina C Dommann-Scherrer, Gerd Stuckmann, Christoph L Zollikofer, Klaus U Wentz
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  ABSTRACT: A case of a right-sided giant cardiac myxoma with malignant transformation of glandular structures causing systemic metastases is described. Plain chest radiography and computed tomography localized the tumor within the heart. Exact depiction of the origin of the tumor using subtracted 2D-projection MR angiography is documented. Radiologic findings and differential diagnosis of this unique tumor are discussed.
  European Radiology 10/2003; 13(9):2099-102. · 3.22 Impact Factor
• Article: High resolution computerized tomography of the chest and pulmonary function testing in evaluating the effect of tobramycin solution for inhalation in cystic fibrosis patients Presented in part at the European Respiratory Society Annual Congress, Glasgow, Scotland from September 4 to 8, 2004, and at North American Cystic Fibrosis Conference, St. Louis, MO from October 14 to 18, 2004.

  Samya Z Nasr, Diane Gordon, Ermelinda Sakmar, Xin Yu, Emmanuel Christodoulou, Boris P Eckhardt, Peter J Strouse
  [show abstract] [hide abstract]
  ABSTRACT: To evaluate the sensitivity of high-resolution computerized tomography (HRCT) of the chest compared to spirometry measures in evaluating the effects of tobramycin solution for inhalation (TSI) in cystic fibrosis (CF) patients.Thirty-two subjects ≥6 years old with mild to moderate CF lung disease were enrolled in a randomized, double-blind, placebo-controlled pilot study. Duration was 28 days; 31 subjects completed the study.HRCT scores decreased 4.06 ± 3.20 (mean ± SD) for TSI and decreased 0.17 ± 1.78 for placebo subjects ( P  = 0.13). Mean forced expiratory flow during middle half of forced vital capacity (FEF 25%–75% ) predicted increased 6.08 ± 4.86 for TSI and decreased 0.60 ± 2.34 for placebo ( P  = 0.23). Percentage forced expiratory volume in 1 s (FEV 1 ) predicted increased slightly for both TSI and placebo (1.29 ± 3.33 for TSI and 1.17 ± 1.4 for placebo) ( P  = 0.97). Two of eight HRCT component scores (atelectasis and inhomogeneity) were observed to be highly discordant with observed HRCT global total score and other HRCT component scores. A modified total score was calculated by dropping them from the global total score. The modified HRCT total scores decreased 6.68 ± 3.09 for TSI subjects and increased 0.02 ± 2.0 for the placebo subjects ( P  = 0.07). Sample sizes were calculated to show statistical significance by differences in modified total HRCT scores, global total HRCT scores, FEF 25%–75% predicted or FEV 1 % predicted. A total of 60, 100, 200, and over 800 patients would be necessary respectively.HRCT can be a useful measure of change in CF pulmonary disease, requiring a smaller sample size than that required to show treatment effect by pulmonary function testing (PFT) alone. Pediatr Pulmonol. 2006, 41: 1129–1137. © 2006 Wiley-Liss, Inc. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/55854/1/20447_ftp.pdf